The prevalence of mental frailty in ICU survivors and informal caregiver strain: A 1-year retrospective study of the Frisian aftercare cohort

Lise F E Beumeler; Carina Bethlehem; Thialda T Hoogstins-Vlagsma; Tim van Zutphen; Hanneke Buter; Gerjan J Navis; E Christiaan Boerma

doi:10.1177/17511437221139547

The prevalence of mental frailty in ICU survivors and informal caregiver strain: A 1-year retrospective study of the Frisian aftercare cohort

J Intensive Care Soc. 2023 Nov;24(4):356-363. doi: 10.1177/17511437221139547. Epub 2022 Dec 7.

Authors

Lise F E Beumeler^{1

2}, Carina Bethlehem², Thialda T Hoogstins-Vlagsma³, Tim van Zutphen^{1

4}, Hanneke Buter², Gerjan J Navis⁴, E Christiaan Boerma²

Affiliations

¹ Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.
² Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
³ Department of Medical Psychology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
⁴ Faculty of Medical Sciences, University Medical Centre Groningen, The Netherlands.

Abstract

Background: Intensive care unit (ICU) survivors often suffer from long-term mental problems and a reduced health-related quality of life (HRQoL). Symptoms of depression, anxiety, and post-traumatic stress disorder may render patients mentally frail post-ICU, resulting in impaired recovery and an increased informal caregiver burden. The aim of this study was to investigate the prevalence of mental frailty up to 12 months after ICU admission and pinpoint markers for early risk-assessment in clinical practice.

Methods: A retrospective cohort study (2012-2018) in which clinical and post-ICU data of long-stay (⩾48 h) ICU-patients was used. Mental frailty was identified as clinically relevant symptoms of depression, anxiety, or post-traumatic distress disorder at 12 months after discharge.

Results: The prevalence of mental frailty at 12 months post-ICU among the total group of 239 patients was 38%. Mental frailty was defined as clinically relevant symptoms of depression, anxiety, and/or trauma. To achieve this, previously validated cut off values were used for the HADS (HADS-Anxiety ⩾ 8; HADS-Depression ⩾ 8) and TSQ (⩾6), and CSI (⩾7).

Conclusion: A significant proportion of ICU-survivors can be identified as mentally frail, which is associated with impaired HRQoL at baseline and post-ICU, and high caregiver strain. These findings emphasize the need for integrative aftercare programs for both the patient and their informal caregivers.

Keywords: Critical illness; frailty; mental health; quality of life.